The Achilles tendon is the largest and strongest tendon in the body, connecting the calf muscles to the heel bone. Because it absorbs force during walking, running, and jumping, it is particularly vulnerable to overuse and injury.
Most Achilles tendon conditions can be treated successfully without surgery when addressed early. Treatment plans are tailored to the specific diagnosis, severity of symptoms, and activity level. If pain, swelling, or difficulty walking persists, evaluation by a specialist can help prevent further injury and support long-term recovery.
Achilles Tendonitis
Achilles tendonitis is the most common Achilles-related condition and occurs when the tendon becomes inflamed due to repetitive stress or overuse. It often develops gradually and is common in runners, athletes, or individuals who suddenly increase activity intensity. Symptoms may include:
- Pain along the back of the heel or lower calf
- Swelling or warmth around the tendon
- Stiffness, especially in the morning or after rest
- Pain that worsens with activity
Treatment for Achilles tendonitis focuses on reducing inflammation, relieving pain, and improving tendon strength and flexibility. Treatment may include:
- Activity modification and rest
- Ice to reduce pain and swelling
- Anti-inflammatory medications, as recommended
- Physical therapy to improve strength and flexibility
- Supportive footwear, heel lifts, or orthotics
Achilles Tendinosis
Achilles tendinosis is a chronic condition marked by degeneration of the tendon fibers rather than active inflammation. It often develops when tendonitis is untreated or repeatedly aggravated. Symptoms of Achilles tendinosis can include:
- Persistent pain that worsens with activity
- Thickening of the tendon
- Reduced strength or endurance in the calf
- Stiffness that does not fully resolve with rest
Treatment for Achilles tendinosis aims to promote tendon healing and reduce ongoing stress. A longer recovery period is often required compared to tendonitis.
- Targeted physical therapy with controlled strengthening exercises
- Activity modification to reduce repetitive strain
- Supportive footwear or custom orthotics
- Advanced non-surgical therapies, when appropriate
- Surgical treatment for severe or persistent cases
Achilles Tendon Rupture
An Achilles tendon rupture is a partial or complete tear of the tendon, typically caused by a sudden, forceful movement such as jumping or pivoting. Symptoms of an Achilles tendon rupture often include:
- Sudden, sharp pain or a popping sensation in the ankle
- Difficulty walking or pushing off the foot
- Swelling and bruising around the ankle
- Weakness when attempting to stand on tiptoes
Treatment of an Achilles tendon rupture depends on the severity of the tear, patient age, and activity level. Prompt care is critical to optimize recovery. Treatment may include:
- Immobilization with a boot or cast
- Physical therapy as healing progresses
- Surgical repair for complete tears or active individuals
- Gradual rehabilitation to restore strength and mobility
Achilles Tendon Bursitis
Achilles tendon bursitis occurs when the bursa between the Achilles tendon and the heel bone becomes inflamed, often due to repetitive friction or pressure. Symptoms of Achilles tendon bursitis often include:
- Pain at the back of the heel
- Swelling or redness near the heel bone
- Tenderness when wearing shoes
- Pain that worsens with activity
Treatment of Achilles tendon bursitis focuses on relieving irritation and reducing pressure on the heel and may include:
- Rest and activity modification
- Ice and anti-inflammatory care
- Footwear changes to reduce heel friction
- Heel pads or orthotics
- Physical therapy to address contributing mechanics
Haglund’s Deformity
Haglund’s deformity is a bony enlargement on the back of the heel that can irritate the Achilles tendon and surrounding tissues, leading to pain and inflammation. Symptoms of Haglund’s deformity often include:
- Pain at the back of the heel
- Redness or swelling near the heel bone
- Discomfort when wearing stiff or tight shoes
- Associated Achilles tendon irritation
Treatment for Haglund’s deformity usually begins with conservative options aimed at reducing pressure and irritation. Other treatment options may include:
- Wearing shoes with a soft or open heel
- Using heel lifts or custom orthotics
- Physical therapy to reduce tendon strain
- Anti-inflammatory treatments
- Surgical correction in persistent or severe cases